Jae Young Lee

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95024373 Issued in CA

Practice address

15095 Amargosa Rd Ste 102
Victorville, CA 92394-1875

Phone

(760) 552-4470

NPI assigned

Mar 27, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1952004095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 S 9TH ST. #119",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906217425",
            "telephone_number": "425-243-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15095 AMARGOSA RD STE 102",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923941875",
            "telephone_number": "760-552-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAE YOUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95024373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Lee
• Andrew Lee, OD
• Benjamin Lee I
• Eunice Lee, PHARMD
• Felix Lee, D.C.
• Jason Lee
• Jeremy Lee, DPT
• Joanne Juyoun Lee, PHARMD, RPH
• John Myung Lee, MD
• Kevin Patrick Lee

• Family Nurse Practitioner in Victorville, CA
• Providers in Victorville, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.